| NPI | 1386656015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARYN LOUISE LOCK-BRYNE Psychotherapist/Site Administrator 810-220-2787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6401005889) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2015-10-01 |